California HealthCare Fraud Lawyers – Defense
In the high-stakes world of healthcare fraud, a fraud allegation in California and its metro areas is more than just a legal challenge—it’s a direct threat to your business future and personal livelihood. Our California healthcare fraud defense lawyers at Watson & Associates, LLC can help.
Running your business and moving forward with your career, free of tarnish and allegations of fraud, overbilling, or having your reputation exposed is your goal. To meet that goal sometimes means dealing with healthcare fraud allegations that have no legal merit. Simply because the government launches an FBO ir DOJ investigation against you does NOT mean that you have broken the law.
Government Investigations | HealthCare Fraud Whistleblower Defense Strategies | Subpoenas & Civil Investigative Demands (CIDs) | FBI, HHS, Office of the Inspector General (OIG) and DOJ Investigations | Medicare Fraud Defense | Indictments | Medical Billing Fraud Defense | Federal Criminal Defense & Trials | Corporate Compliance | Internal Investigations | Health Care Fraud Investigations Defense
If you have been accused of defrauding Medicare, Medicaid or a private health insurance company, you could be facing a prison sentence and other substantial federal civil or criminal penalties. It is important to retain an experienced healthcare fraud law firm and criminal defense attorney as soon as possible.
If you made an honest mistake, acted responsibly or even never intended to commit fraud against the government or any health care organization, there is a chance that you can be exonerated. To accomplish this goal, you want a. solid team that is dedicated to getting some results. This is where our California healthcare fraud defense lawyers and attorneys come in.
What Is Healthcare Fraud?
The Health Care Fraud Statute, codified under 18 USC 1347, makes it a federal offense to intentionally and knowingly defraud a healthcare benefit program. This law also covers attempts to commit such fraud, treating them with the same severity as the crime itself.
For physicians, pharmacists, and other healthcare providers in California, being accused of healthcare fraud is a serious and complex matter. The implications of such an accusation are far-reaching and multifaceted, creating significant challenges when facing healthcare fraud investigations by federal agencies such as the DOJ, DEA, OIG, or others. A federal investigation into “healthcare fraud” can arise from a variety of alleged actions, depending on the specific circumstances involved. This includes:
- Providing and billing for medically unnecessary services
- Billing for services not actually rendered to patients
- Falsifying patient records, prescriptions, physician certifications, and election statements
- Offering or accepting illegal “kickbacks” or referral fees
- Prescribing opioid medications to drug-dependent patients, diverting opioid prescriptions, and other forms of prescription drug fraud
Types of Medical Fraud Cases
- Upcoding;
- Duplicate claims;
- Medically unnecessary services;
- Non-rendered services;
- Kickbacks;
- Stark violations;
- Trade Agreements Act
- Drug diversion; or
- Other fraud-related allegations.
What are Possible Legal Defenses to HealthCare Fraud?
There are some potential legal defenses to healthcare fraud charges:
Lack of Intent or Mistake – To commit fraud under health care fraud rules , you must have the requisite legal intent to cheat the government or insurer out of money. If you acted in good faith but made a mistake, accidentally omitted information, made an error, or made a mistake in billing, you cannot be convicted of health care fraud.
Insufficient Evidence – The government must have evidence of your intent to defraud and enough evidence to prove beyond a reasonable doubt. Without sufficient evidence, you cannot be convicted.
Compliance Program – An experienced California healthcare fraud criminal defense lawyer and False Claims Act attorney can help you by directing the fact of your case and aggressively surmounting a solid legal defense. Evidence of a comprehensive compliance plan can be used to show you lacked intent to engage in health care fraud.
Consent – You do not commit fraud if you were granted permission for your actions by the alleged victim. Evidence you were given permission to do what you are accused of is a defense against the charges.
Are you equipped with the right legal strategy to protect and defend your practice and your reputation before it’s too late?
Healthcare providers throughout California and its metro areas are targeted by HHS, DEA, DOJ and other law enforcement agencies in high-stakes federal healthcare fraud investigations.
If you or the company have received a target letter, Civil Investigative Demand, or subpoena for a criminal case, immediately send our California healthcare fraud criminal defense lawyers.
California Healthcare Fraud Defense Lawyers
Most California healthcare fraud cases allege that a medical provider or a healthcare business (lab, pharmacy, hospital, home health agency) has submitted fraudulent billing claims to Medicare, Medicaid, Tricare, or a commercial insurance company.
Please that true billing mistakes lack the intent that the government seeks to prove. Watson & Associates, LLC California healthcare fraud defense lawyers know that federal prosecutors make mistakes. As a result, our legal team puts forth a rigorous legal defense in both civil and criminal cases. Please call us at 1.866.601.5518.
Medical Billing Fraud Attorney – Who Can Face Medicare Fraud Charges in California
Both beneficiaries and Medicare providers can face charges of insurance fraud. Whether you are a medical care provider such as a physician, nurse, or medical billing employee; or you are a patient charged with fraud, you should retain a California healthcare insurance fraud lawyer immediately.
Some of the common reasons a provider can federal medical billing fraud charges:
- Overbilling of Services – Medicare providers who have not performed services and have billed for them could face criminal charges of fraud. These charges are very serious as they could ultimately result in the provider being banned from receiving any type of payment from these programs. False diagnosis is also another common way providers have defrauded Medicaid and Medicare.
- Violation of Stark and Anti-Kickback Laws – medicare providers are prohibited from referring patients to other providers in return for any type of financial gain. This includes referrals for any type of services including laboratory work, physical therapy, second opinions, etc. All types of providers and medical billing companies are bound by these rules. At Watson & Associates, LLC our federal medical billing fraud lawyers are here to help you to defend your case.
- Up Billing Patients – when a hospital, physician’s office or a billing company improperly codes procedures or they bill services individually when they are offered as a “bundle”. All submissions for reimbursement must be properly coded and if a pattern of abuse is discovered the Medicare provider could face federal criminal fraud charges.
California FBI Healthcare Fraud Defense Attorneys
If you are facing an FBI investigation, indicted or facing federal charges for healthcare fraud, you should seek legal counsel from an experienced California FBI healthcare fraud lawyer. If your company or home was raided by the FBI and search warrants were involved our criminal defense attorney can help.
Companies and Individuals Have Become Targets for HealthCare Fraud Across the United States
Legal civil and criminal defense for healthcare fraud California: For many healthcare providers, manufacturers, and small and large businesses, participating in federal government benefit programs such as Medicare, Medicaid, and Tricare is essential to maintaining their financial success. When investigated for health care fraud, federal investigations can be intrusive, scary, and complex.
Your company is subjected to Health Care Fraud False Claims Act charges. This makes you subject to both civil and criminal penalties. The most common health care fraud charges involve alleged overbilling of healthcare services and billing of medical services not rendered. These charges may be brought against doctors, hospitals, home health care agencies, pharmacies and many other types of medical service providers.
Federal Healthcare providers in California and nationwide are being targeted in federal healthcare fraud and False Claims Act investigations. Failure to secure the proper legal defense can expose you to jail time and serious fines. It’s time to find and hire an experienced criminal defense attorney and California healthcare fraud defense lawyer.
You Have Constitutional Rights that the Government Cannot Cross When They Are Trying to Take Your Life, Liberty or Property Away. Let Us Help You Protect Those Rights
Who Are Our Clients
- Physicians;
- Physician assistants;
- Nurses;
- Physical and occupational therapists;
- Pharmacies;
- Pharmacists;
- Drug manufacturers;
- DME suppliers;
- Hospitals; and
- Clinics
Practice Lead (US Supreme Court Licensed)
Call our healthcare qui tam defense attorneys and federal California healthcare fraud lawyers today for a Free Initial Consultation at 1.866.601.5518.
Speak to Theodore Watson. Top False Claims Act healthcare fraud criminal defense lawyers for small businesses and large corporations nationwide.
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Multiple Offices
- Washington, DC
- Denver, CO
- Miami, FL,
- Los Angeles, CA
- Dubai
We can handle federal cases in every state. Watson’s California healthcare fraud criminal defense attorneys serve Los Angeles, San Diego, San Jose, San Francisco, Long Beach pharmaceutical fraud attorneys, Sacramento, Fresno healthcare fraud defense attorneys, Oakland healthcare compliance defense attorney, and surrounding metro areas. We will comb the facts of your case, develop the strongest legal defense, and aggressively fight back.
Federal False Claims Act
California Medicare fraud criminal defense lawyers: The False Claims Act (FCA) imposes civil and criminal penalties for the submission of “false or fraudulent” claims for payment by the federal government – including payment under Medicare, Medicaid, Tricare, and other federal healthcare programs. This includes intentional and unintentional billing and coding errors, as well as various other forms of healthcare fraud.
Civil penalties under the FCA include fines, recoupments, treble damages, and program exclusion. Criminal penalties include fines and federal imprisonment. Call our California healthcare fraud defense lawyers for immediate help.
Federal Healthcare Fraud Penalties (18 USC 1347)
A violation of 18 USC 1347 in California for federal healthcare fraud is punishable by:
- a maximum of 10 years in federal prison and/or
- the imposition of a fine
Federal healthcare fraud criminal convictions and penalties can result in up to 10 years in prison and fines of up to $250,000, with harsher penalties for serious bodily injury or death, potentially leading to a life sentence. If, a criminal violation results in serious bodily injury to any individual, the maximum confinement time is increased to 20 years. If the healthcare fraud violation results in death, the maximum punishment increases in federal prison.
18 USC 1349 provides that a conspiracy to commit healthcare fraud may be punished in the same fashion as the healthcare fraud itself, so the maximum punishments would be:
- 10 years, 20 years, or life in federal prison depending on if the enhancements for injury or death are applicable
As Federal California Healthcare fraud defense lawyers, we understand knowledge that the fraudulent conduct is illegal, much less knowledge of the specific provision of federal law which prohibits health care fraud, is not required for a jury conviction under these statutes.
If the defendant knows that the statements or representations they made to obtain money or services through a federal healthcare benefit program are fraudulent, that is enough to convict regardless of whether the defendant understood that their conduct was illegal.
Immediate Help from Watson & Associates LLC
Whether you. are under federal investigation, presented with a civil investigative demand (CID) or subpoena, or being indicted by a grand jury, our California healthcare fraud criminal defense lawyers and healthcare defense attorneys are here to help.
Contact Our California Health Care Enforcement Action Defense Lawyers
As 18 USC 1347 federal California Healthcare fraud defense lawyers, we represent clients and federal courts in California healthcare fraud cases under 18 USC 1347,. Please contact us to schedule a FREE initial consultation. Speak to our lead attorney, Theodore Watson, directly.